HomeMy WebLinkAboutBuilding Permit Application - a
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: "��'l �� Permit Number:ytol-(3035
A
"RECEIVED
Building Permit Application. 2 1�t8
Planning and Development Services
Building and Code Regulation Division Count
2300 Virginia Avenue,Fort Pierce FL 34982 _ Y, Permitting
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED LIVIPROVEMENT LOCATI(?N ;t
R`-
Address: 6120 Spring Lake Terrace
Legal Description: PORTOFINO SHORES-PHASE THREE- (PB 43-40) LOT 375 (OR 3374-2212)
Property Tax ID#:''tl312-503-0148-000-4 Lot No.375
Site Plan Name: KARL E. MANKE Block No.
Project Name: KARL E. MANKE
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORKTIM
3
INSTALLATION OF HURRICANE SHUTTERS-TEN(10)OPENINGS/ACCORDION
r
CONSTRUCTION INFOR � '' `� � ��
Additional work to be nertormed un er t is permit—check all appy:
❑HVAC Gas Tank []Gas Piping f%ll( Shutters a Windows/Doors
Electric Plumbing O Sprinklers E]Generator E] Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 6,421.57 Utilities:FJ Sewer Septic Building Height:
Name KARL E. MANKE Name: MIRIAM VAN TASSEL
Address:6120 Spring Lake Terrace Company: DVT HURRICANE SHUTTERS, INC.
City: Fort Pierce State:FL Address: 3100 N KINGS HIGHWAY
Zip Code: 34951 Fax: City: FORT PIERCE State:FL
Phone No.231-632-2670 Zip Code: 34951 Fax: 772-794-1590
E-Mail:karjoyman@yahoo.com Phone No. 772466-4575
Fill in fee simple Title Holder on next page(if different E-Mail: dvthurricaneshuttersinc@hotmail.com
from the Owner listed above) State or County License: 24394
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
S'UPPLEIVIENTAL �ONSTRUCTf:ON LIEN LAW INFORMATIOIt u
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
.accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
i
Signatur c f Owner/Lessee/Contractor as Agent for Owner Signature o Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF—6)r. %_40c%4*, COUNTY OF S k. L\)6&
Th forgoing instrument was acknowledge before me The forgoing instrument was acknowledgej before me
this& day ofJ��I ,20A by this�day of $ J Y 20 by
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
1, ,DEANN P= n,mtiic
NNNAMARIEci I- �
(Signature of Notary Publ# a.�C�f Florid (Signature of Not Pub( $fate�b`f�Fflihi'MtipN#Gc022c ,
MY C �9iJfISSION#GG 022023 b I ;: ��� o; EXPIRES:December 96,202U
}S:December 16,2020 �i' ael� Bonded Tfuu p! '
Commission No. As � ti'O' fir' '}�r r� p� cUnderx�iiers
,;aotF��. Bon c i�uNotaryPubiicUndenvrter commission No. lsdF)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17